Secret Agent Society: Establishing an Innovative Social Skill Intervention within a Community Mental Health Setting: Initial Adoption (CHLA USC UCEDD)
April 25, 2014
Post-doctoral Psychology Fellows admitted to Children's Hospital Los Angeles's (CHLA) APA-accredited training program at the USC University Center for Excellence in Developmental Disabilities (UCEDD) enjoy the opportunity to train in innovative and evidence based treatment interventions focusing upon reducing challenging behaviors, coping with trauma-exposure, and enhancing attachment. A broad variety of evidence-based interventions have been used in the behavioral clinics at CHLA; however, most of these evidence-based interventions were developed to serve typically developing children and their caregivers. Since CHLA's psychology fellows also participate in the UCEDD's Leadership in Neurodevelopmental Disorders program, CHLA's faculty and fellows have been interested in expanding evidence-based training opportunities to include interventions focusing upon socio-emotional challenges facing children with neurodevelopmental disorders. In the spring of 2012, Dr. Brad Hudson and psychology fellows within CHLA's Child and Family specialty initiated a pilot project to explore the use of The Secret Agent Society (SAS), a novel social skills training program proven efficacious in clinical trials in Australia. This submission represents the first of four submissions to the AUCD Digest which will describe the progress of this pilot project from initial training, thru pre-pilot group delivery, expanded training and expansion of group trials, as well as the development of research proposals seeking funding to replicate clinical trials of this promising practice within the United States.
The SAS is a social skills small group intervention developed by Renae Beaumont Ph.D. of the University of Queensland and other researchers in Australia. SAS has been shown to be effective at increasing social skills in participants diagnosed with High Functioning Autism, as well as improving knowledge of effective emotional regulation techniques (Beaumont & Sofronoff, 2008). SAS features a multi-dimensional approach incorporating the use of group dynamics, parent and teacher support, and a sophisticated, multi-level computer game incorporating an espionage theme to teach skills in a fun environment. Heather Hall, PhD, was the first of CHLA's psychology fellows to participate in training conducted in Florida during the fall of 2012. The two-day training, led by Dr. Kathleen Davey, the SAS developer's senior training coordinator, highlighted important aspects of the interactive computer game that the children play in their home as well as the nine week curriculum by making use of role plays, small group discussions and video clips of previous groups to introduce the training techniques incorporated in the intervention.
Following initial training in SAS, Dr. Hall shared her training experience with faculty members and her colleague psychology fellow, Whitney Ence, PhD. The two fellows designed a pre-pilot group and recruited three children with ASD, and the group began meeting in the spring of 2013. The SAS pre-pilot intervention included an intake meeting with the parents, a nine-week group program for the children and parents, weekly communication with teachers and a three-month follow-up. The two boys and young girl were introduced the first evening over an informal meal that was served weekly to reduce barriers to attendance for the families given the time and length of the group that met for 120 minutes during the evening. Unfortunately, the young girl was unable to maintain attendance for the group due to transportation issues; however, the remaining two members were consistent participants throughout initial trial of the intervention, with both parents and teachers noting improvements in their behaviors in the home and at school. Additionally, an unplanned outcome of the pre-pilot group has been that the initial members have maintained their friendship and continue to meet on the weekends for 'play dates.'
In the Fall of 2013, the SAS intervention expanded to include additional staff members and trainees from psychology and occupational therapy (OT) who participated in an on-site SAS training led by Dr. Davey of SAS. CHLA psychology fellows and OT faculty are currently running two parallel groups of six children simultaneously at the clinic. In addition, the project has prompted a scholarly paper that will be submitted for publication, submissions for external grant to fund a replication of Dr. Beaumont's study in Australia, as well as a submission requesting funding to enable the materials to be translated into Spanish to better serve our population at the clinic. The successes and challenges of this process will be further highlighted in upcoming issues of the AUCD Digest, including a discussion of individual accommodations made for children in the group with disruptive, challenging behaviors, accommodations for Spanish-speaking caregivers, and outcomes from the current round of expanded services delivery.
Beaumont, R., & Sofronoff, K. (2008). A multi-component social skills intervention for children with
Asperger syndrome: The Junior Detective Training Program. Journal of Psychology and
Psychiatry, 49, 743-753.
Heather J. Hall, PhD and Bradley O. Hudson, PsyD
USC/UCEDD at Children's Hospital Los Angeles